Whitesburg KY

Hiatal hernia can become traumatic



DEAR DR. DONOHUE: Our experience with my husband’s hiatal hernia was traumatic. He was 69 and in excellent health. After a day of working in the yard, we sat down to supper and within three minutes he was incapacitated with chest pain. He was taken to the hospital and was given nitroglycerin for the pain. The pain subsided as quickly as it came. It took two months to discover the real problem: His stomach was in his chest cavity and had crowded his heart and lungs. Surgery was scheduled. Before the scheduled date, the pain returned and he had to have emergency surgery. Please let people with a hiatal hernia know about this. — M.H.

ANSWER: People have been led to believe that a hiatal hernia is the same as GERD, gastroesophageal reflux — heartburn; it isn’t. They are two different conditions. A hiatal hernia is a bulging of the stomach through a gap in the diaphragm muscle, the muscle that separates the chest cavity from the abdominal cavity. The gap is the hiatus, and through it, the esophagus can pass from the chest into the abdomen to join the stomach.

GERD can happen to people with a hiatal hernia, and it can happen to people without a hiatal hernia. Your husband’s problem was a somewhat rare complication of a hiatal hernia. The upward bulge of his stomach, the portion in the chest, twisted and cut off its own blood supply. That’s what caused his pain. The first time, the hernia untwisted spontaneously and the pain left. The second time, the twist didn’t untwist, and emergency surgery was required.

This process is called strangulation and is a very serious affair. Thankfully, it happens only to a very few. You’ve provided a chance for people to learn what a hiatal hernia is, what a strangulated hiatal hernia is and what GERD is. We’re all glad that things worked out well for your husband.

The booklet on hiatal hernia, acid reflux and heartburn focuses primarily on the common heartburn problem and its treatment. Readers wanting more information can obtain a copy by writing: Dr. Donohue — No. 501W, Box 536475, Orlando, FL 32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have two granddaughters who bite their fingernails. Is there anything that stops this awful habit? — B.S.

ANSWER: What prompts people — children and adults — to bite their nails is often unexplainable. Stress, boredom, imitation of other nail-biters and relief of anxiety are offered as explanations for the habit, but proof is lacking for a cause in most cases. Close to 60 percent of 10- year-olds bite their nails. As children grow older, the number of nail-biters lessens.

Doing nothing about it is often the best policy. If the child wants to stop, then there are ways to help him or her break the habit. When children are at home, Band-Aids over the fingers remind them not to bite. Chewing sugarless gum makes nailbiting less convenient. Readers are welcome to give us their solutions.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475.

©2008 North America Synd.

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